MEDICARE: MARGARET ANN BERESFORD MC, ATR-BC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-1768	AZ

General Provider Information

NPI Number	:	1003326638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET ANN BERESFORD MC, ATR-BC, LPC

Provider Business Mailing Address
First Line	:	4545 N. 36TH STREET
Second Line	:	SUITE 117
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5344
Country	:	US
Telephone Number	:	602-509-5771
Fax Number	:

Provider Business Practice Location Address
First Line	:	4545 N. 36TH STREET, SUITE 117
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5473
Country	:	US
Telephone Number	:	602-509-5771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	03/06/2020

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